大鼠体外循环基础上应用停跳液心脏停跳模型的建立

The establishment of Cardioplegic Arrest model on the basis of general cardiopulmonary bypass in rats

目的:在大鼠普通体外循环(CPB)模型基础上,建立灌注心停跳液心脏停跳(CA)模型,比较CA模型与普通CPB模型实验大鼠心肌缺血再灌注损伤情况;观察CA模型大鼠术后的存活和恢复情况。方法:借助血管穿刺置管技术,在大鼠普通CPB模型基础上,通过右侧颈总动脉置入双腔气囊导管,充气套囊、阻断升主动脉及灌注心脏停跳液使心脏停搏。比较CPB模型大鼠(n=6)和CA模型大鼠(n=15)心肌缺血再灌注损伤的区别;分别在术后1 d、1周和2周3个时点观察CA模型大鼠恢复情况(n=5)。结果:CA大鼠在心脏缺血再灌注60 min后,心型脂肪酸结合蛋白(HFABP)和心肌肌钙蛋白I(cTnI)明显高于术前基础值和普通CPB组水平,在复灌后3 h达到顶峰,术后1 d降低,在术后1周和2周的观察时点回降至术前水平。左心室射血分数(EF)在2组动物之间差别不大;舒张早期血流峰值/舒张晚期血流峰值比值(E/A比值)在CPB后降低,而在CA后进一步下降。CA组大鼠均存活,但术后质量明显降低,在术后1周时最为显著,2周时大鼠质量已经恢复,并且超过术前水平。结论:本实验在普通的CPB模型基础上成功的建立了CA模型。同普通CPB模型大鼠相比,CA模型大鼠在CPB心脏缺血再灌注后,出现了明显的心肌损伤。CA大鼠具有较高的存活率。

Objective：To establish cardioplegic arrest （CA） model on the basis of general cardiopulmanary bypass （CPB） in rats; to compare the myocardial ischemia-reperfusion injury related to CA and CPB and to observe the survival and the recovery status of CA in rats. Method： A double-lumen balloon catheter was cannulated through the right carotid artery into the ascending aortic artery. The cardioplegic arrest was achieved by intraaortic clamping through balloon inflation and by cardioplegia infusion. To compare the myocardial ischemia-reperfusion injury related to CA and CPB and respectively observe the survival and the recovery of CA rats at 1 day, 1 week and 2 weeks after cardioplegic arrest. Result： At sixty minutes after cardiac arrest, HFABP and cTnI were significantly increased compared with baseline and the rats in CPB group, reached peak value at 3 hours after reperfusion, reduced 1 day postoperatively and returned to baseline levels at 1 and 2 week. Left ventricular ejection fraction didn＇t show obvious change between CA and CPB group; E/A ratio was reduced after CPB and further reduced after CA. All rats survived with significant body weight loss 1 day and 1 week postoperatively but fully recovered 2 weeks after surgery. Conclusion：The cardioplegic arrest model is successfully established on the basis of general CPB model in rats. CA rats showed significant myocardial injury but presented a satisfactory survival rate.